This paper reports the findings of a qualitative Australian study where 13 transgender or gender diverse adults were interviewed about family relationships. The findings indicate the degree to which participants were concerned with protecting family members from the perceived disruption to family life that transitioning can bring about. Protecting family relationships, however, often occurred at the expense of the transgender or gender diverse person as they slowed or halted their transition out of concern for family members’ well-being or the need to preserve relationships. Participants reported low levels of support from health services for family members at the time of transitioning, particularly around supporting families to have conversations about the impact of transitioning on the family unit. We argue that the health and well-being of transgender and gender diverse people rely on positive relational support from, and for, families experiencing the gender transition of a family member.